Individual provider Active NPI

Ryan Bennion, DO

  • Emergency Medicine Physician
  • Eglin Afb, FL
National Provider Identifier
1083290639
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20321 Issued in CA
Practice address
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone
(850) 883-8227
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS22941 FL
Emergency Medicine Physician 207P00000X 20321 CA Primary

Addresses

Primary practice location

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Mailing address

307 Boatner Rd
Eglin Afb, FL 32542-1302
Phone (850) 883-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240827001955 CA Practitioner - Emergency Medicine 3072052638 Reassigns benefits to 1 organization
I20260414002747 FL Practitioner - Emergency Medicine 3072052638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1601 Cummins Dr
Suite D
Modesto, CA 95358-6403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS22941FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California Emergency Medicine CurrentSince Jun 17, 2024 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 17, 2024 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1141 Rose Ave
Selma, CA 93662
Phone (559) 790-2800

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1083290639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNION",
        "first_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS22941",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin Afb, FL

Sources for this page

Verify at the official NPI Registry.